Quality Improvement (QI) Service Tiers
Changes in reporting clinical guidelines, compensation, coding, compliance and quality measures are intended to improve patient outcomes by emphasizing value over volume but the learning curve can be steep.
Our Quality Improvement (QI) team has developed new service level tiers to help healthcare practices transition to new payment models and optimize the benefits for their patients and to the bottom line. We offer a range of different service tiers to meet your needs and your budgets.
QI Service Tiers include:
Hierarchical Condition Category Risk Coding – Payments are underscoring the importance of risk adjustment and offering compensation for practices able to make up for the extra costs associated with high-risk enrollees. Hierarchical Condition Category (HCC) coding is a risk-adjusted model originally designed to estimate future healthcare costs for patients. Risk adjustment could positively impact your overall cost measure score. CORHIO’s QI team can help you code correctly to increase reimbursements and ensure adequate documentation to support coding.
Process Improvement Coaching Services – Colorado is among 26 states participating in CMS’s Primary Care First (PCF) program, which offers an innovative payment structure to support the delivery of advanced primary care by rewarding value and quality. A PCF practice must meet certain standards in order to be eligible for a positive performance-based adjustment to their primary care model payments. CORHIO’s QI team offers Process Improvement Coaching Services to optimize the benefits of PCF and other value-based models. For PCF practices, CORHIO recommends adding the HCC Risk Coding package and/or the eCQM package to support additional needs associated with value-based care. Discounts would be offered on other packages for overlapping work.
Quality Payment Program Reporting Support – The Quality Payment Program (QPP) is one of several programs that intends to change the way Medicare reimburses healthcare providers by moving toward value over volume. Our QPP Reporting Support service is aimed at quality improvement support and guidance on reporting specifications. Per CMS, 2021 performance-year data will need to be reported by March 31, 2022. As a CMS-defined Qualified Registry for the QPP program, CORHIO can also aggregate, calculate, validate and submit measures on the client’s behalf with a separate fee. Contact your CORHIO representative for more details.
Electronic Clinical Quality Measures Reporting -- Electronic Clinical Quality Measures (eCQMs) help measure and track the quality of healthcare services that eligible professionals and hospitals provide -- as generated by a provider's electronic health record (EHR). CORHIO's QI team can help practices meet the ever-changing criteria in eCQM reporting to improve reimbursements and patient care.
To discuss the Quality Improvement Service Tiers with our team, please Contact Us.